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Updated: Oct 4, 2025
08:49
External Cephalic Version: Is it an Effective and Safe Procedure?
Published on: June 6, 2020
14.8K
Ritodrine versus salbutamol for external cephalic version.
Gabriel Levin1, Tal Cahan2, Yishay Weill3
1Department of Gynecologic Oncology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel - levin.gaby@gmail.com.
Minerva Obstetrics and Gynecology
|February 2, 2022
Summary
Intramuscular ritodrine significantly improved external cephalic version (ECV) success rates compared to subcutaneous salbutamol. Both beta-agonist tocolytics were safe and acceptable prior to ECV procedures.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Maternal-Fetal Medicine
Background:
- Beta-agonist tocolytics enhance external cephalic version (ECV) success.
- Intramuscular (IM) and subcutaneous (SC) administration routes are understudied compared to IV and oral.
- Comparing IM ritodrine to SC salbutamol prior to ECV is crucial.
Purpose of the Study:
- To compare the efficacy of IM ritodrine versus SC salbutamol for improving ECV success rates.
- To evaluate the safety and acceptability of these administration routes before ECV.
Main Methods:
- Retrospective study of 1202 patients undergoing ECV (2012-2019).
- Groups matched by parity and placental location.
- Comparison of maternal, pregnancy, ECV, and neonatal characteristics.
Main Results:
- IM ritodrine group showed higher ECV success rates (71.7% vs. 63.8%, P=0.003).
- Higher vaginal delivery rates observed in the ritodrine group (70.7% vs. 60.1%, P<0.001).
- Ritodrine independently associated with increased ECV success (aOR 2.1).
Conclusions:
- Intramuscular ritodrine significantly improves ECV success rates compared to SC salbutamol.
- Both IM ritodrine and SC salbutamol are safe and acceptable tocolytic options before ECV.
- Further research into alternative administration routes for tocolytics is warranted.
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